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2008, Number 3

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Rev Mex Cir Pediatr 2008; 15 (3)

Adjuvant Therapy Management with VAC (Vacuum-Assisted Closure) in Intestinal Tuberculosis (TBI): A Case Report

Gil-Vargas M, Ocampo-Martínez H, Victoria-Morales G, Hernández-Davy C

Language: Spanish
References: 23
Page: 140-144
PDF size: 59.62 Kb.


ABSTRACT

Introduction: The Vacuum - Assisted Closure (VAC) therapy is a very helpful tool in the management of infected areas in adults. In the pediatric population there are few reports of this kind of therapy. In the intestinal tuberculosis (TBI) with bowel perforation there are a granulomatous infiltration. Basically, the operative management consists in intestinal derivations. We document a case with intestinal tuberculosis with multiple bowel perforation using VAC therapy for 11 days.
Case Presentation: 9 year old boy with pulmonary tuberculosis 3 years before without medical treatment. His chief complain was fever, gastric vomit, colestasis and maisless. The physic exploration shows acute abdomen and the abdomen Rx with bowel perforation. At the operation we found multiple bowel perforations at the ileon
Discussion: The entero-entero anastomosis is contraindicated in contaminated areas so that intestinal derivations are mandatory. In high output enteric fistulas, we decided to use the VAC therapy with serial change of sponges and hermetic sails in the abdominal wall. We prevent operative management until the closure of the enteric fistula. For that reason, the VAC therapy is highly recommended in infected areas.


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